Can marijuana help mitigate America’s opioid crisis?

Members of the President Donald Trump’s Commission on Combating Drug Addiction and the Opioid Crisis will hold their first meeting today.

The Commission is tasked with studying “ways to combat and treat the scourge of drug abuse, addiction, and the opioid crisis” — the latter of which was responsible for more than 30,000 overdose deaths in 2015.

Given the makeup of the commission — which includes a number of longtime drug warriors such as New Jersey Gov. Chris Christie, former Rhode Island Rep. Patrick Kennedy, and former Office of National Drug Policy Control staffer Bertha Madras, who once opposed the use of opioid overdose rescue drugs like naloxone — it is unlikely that these discussions will include any talk of the potential role that cannabis can play in mitigating drug dependence, particularly opioid abuse.

{mosads}That’s unfortunate because the available evidence shows that legal cannabis access is associated with reduced levels of opioid abuse and mortality, as well as declines in the use of other addictive substances.

Here’s a look at some of the more relevant scientific findings:

• A 2014 study published in JAMA Internal Medicine reported that states where medical cannabis was legal experienced year-over-year declines in opioid-related overdose deaths compared to those states where marijuana remained illegal. Authors determined, “Examination of the association between medical cannabis laws and opioid analgesic overdose mortality in each year after implementation of the law showed that such laws were associated with a lower rate of overdose mortality that generally strengthened over time: year 1 ( down 19.9 percent), year 2 ( down 25.2 percent), year 3 ( down 23.6 percent), year 4 ( down 20.2 percent), [and] year 5 ( down 33.7 percent).”
• A 2015 report by The RAND Corporation found that “states permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not.”
• A 2016 study published in The Journal of Pain determined that chronic pain patients reduce their use of opioids by more than 60 percent after initiating medical cannabis therapy. A separate study published that same year in The Clinical Journal of Pain similarly reported a 44 percent decrease in prescription opioids among pain patients provided medicinal cannabis. 
• A 2017 study published in The Journal of Drug and Alcohol Dependence reporting that opioid-related emergency room visits fall significantly following the enactment of medical marijuana regulations. “Medical marijuana legalization was associated with 23 percent and 13 percent reductions in hospitalizations related to opioid dependence or abuse and opioid pain reliever overdose, respectively,” authors concluded.
• A 2017 economic analysis published in the journal Health Affairs concluding that patients spend significantly less on prescription opioids in medical cannabis states as compared to those jurisdictions where the plant remains illegal.

Emerging scientific evidence also indicates that cannabis can serve as a path away from dependency upon more dangerous substances — including alcohol, prescription drugs, cocaine, and tobacco. For example:

• A 2017 study published in the Journal of Psychopharmacology reported that patients recommended medical cannabis significantly reduced their consumption of anti-anxiety medications and alcohol. 
• A 2017 study published in The International Journal of Drug Policy finding that medical cannabis access was associated with the decreased use of tobacco. Separate clinical trial data published in the journal Addictive Behaviors previously reported that tobacco-smoking subjects randomly administered cannabidiol – an organic constituent in the marijuana plant – reduced their cigarette intake by greater than 40 percent. 
• A 2017 study published in Addictive Behaviors determining that those dependent on crack cocaine subsequently reduce their drug use following the intentional use of cannabis. Authors concluded: “In this longitudinal study, we observed that a period of self-reported intentional use of cannabis … was associated with subsequent periods of reduced use of crack [cocaine]. … Given the substantial global burden of morbidity and mortality attributable to crack cocaine use disorders alongside a lack of effective pharmacotherapies, we echo calls for rigorous experimental research on cannabinoids as a potential treatment for crack cocaine use disorders.”

With opioid overdose deaths having risen four-fold since 1999, it is imperative that lawmakers and public health experts approach this issue with an open mind and remain willing to entertain all potential alternatives.

For many patients, cannabis provides a safe and effective substitute for the use of opioids and other potentially harmful substances. Committee members should set their political ideologies aside and give strong consideration to this rapidly growing body of scientific evidence.

Paul Armentano is the deputy director of the National Organization for the Reform of Marijuana Laws and is the co-author of the book “Marijuana Is Safer: So Why Are We Driving People to Drink?” (Chelsea Green Publishing, 2013).

The views expressed by contributors are their own and are not the views of The Hill.